维持糖尿病 在实用试验后共享医疗预约
Andrea L Nederveld1, Dennis Gurfinkel2, Julia Reedy2
1From the Department of Family Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO (ALN, REG, JAW, JSH); Adult and Child Center for Outcomes Research and Delivery Science, Children's Hospital Colorado and University of Colorado Anschutz Medical Campus, Aurora, CO (DG, JR, REG. JAW, BMK, JSH); Department of Emergency Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO (BMK). andrea.nederveld@cuanschutz.edu.
糖尿病共享医疗预约 (SMA) 是有价值的,但很难维持. 初级保健团队需要更好的补偿模式和政策变化,以确保这些重要糖尿病自我管理教育和支持服务的长期成功.
科学领域:
- 主要护理是指初级护理.
- 医疗保健服务研究 医疗服务研究
- 糖尿病管理 糖尿病管理
背景情况:
- 糖尿病共享医疗预约 (SMA) 在初级保健机构提供糖尿病自我管理教育和支持 (DSMES).
- 在初始实施后维持SMA对初级保健实践提出了重大挑战.
研究的目的:
- 从初级保健实践成员的角度了解影响糖尿病SMAs可持续性的因素.
- 通过实用性试验,确定SMA长期实施的障碍和促进因素.
主要方法:
- 一项定性研究涉及79次采访,对20家初级保健实践的成员进行了采访,这些实践人员参加了"投资于糖尿病"实用试验.
- 分析采用了基于理论的解释性编辑方法来探索SMA可持续性的经验和观点.
主要成果:
- SMA被认为是有价值的,但可持续性计划在实践中不一致.
- 可持续发展的关键主题包括实际的运营因素 (一些不受当前支付模式的支持),相关性和效率的需求,以及提高质量措施的激励.
结论:
- 初级保健团队有动力提供糖尿病SMA,但可持续性受到当前医疗保健报销结构的阻碍.
- 政策变化,医疗保健支付创新和新型退款模式对于提高SMA的可持续性和改善患者结果至关重要.
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